Why men should also care about UTIs?
Urinary tract infection (UTI) is generally caused by bacteria from the intestine that reach the urinary system. This infection is more common in women because of the female anatomy — i.e. proximity of the anus with the urethra.
Urinary tract infection is more common in men: (1) after 50 years of age; (2) who are more at risk of suffering from prostate hyperplasia (benign enlarged prostate); (3) who practice anal sex; (4) who are uncircumcised; or (5) with some problem that blocks the exit of the urine or using a tube to urinate.
What are some symptoms that should lead a man to visit his doctor?
The most frequent symptoms of urinary tract infection are:
- discomfort in the lower abdomen;
- pain and/or burning sensation while urinating;
- feeling of not being able to empty the bladder;
- cloudy urine and unpleasant smell — sometimes containing blood; bad-smelling urine may be a sign of the presence of bacteria, and the source of bacteria may be cystitis or urethritis;
- constant urge to urinate, as well as difficulty holding urine, with the patient sometimes failing to reach the bathroom in time and urinating involuntarily — this called urinary urgency and is more present in children and the elderly; and
- Mild fever between 37.5°C and 38°C
In cases of infections complicated by kidney conditions, there is often pain in the lower back, which can be mistaken by renal colic, high fever with or without chills, nausea, and vomiting.
For men over 50 years of age, the prostate — a gland located near the bottom of the bladder, surrounding the start of the urethra — can increase in size and block the flow of urine from the bladder. This condition is known as benign prostatic hyperplasia. The patient can become unable to empty their bladder completely, increasing the likelihood of bacteria proliferation and infection. Treatment options in this case may include medication or even surgery. Other types of treatment that may be needed are corrections of urinary obstruction, stone extraction, correction of general factors, such as immunodepression and diabetes, which generally increase the tendency of patients to more serious infections.
There are other habits and diseases that can be predisposing factors for UTI. For example, low fluid intake, partial and/or infrequent emptying of the bladder, the reflux of urine from the bladder to the kidneys, kidney stones, tumors, and changes in bladder functioning, diabetes or chronic prostatitis.
UTI may not show symptoms and signs, and doctors discover it only when performing routine urinary tests.
The good news is that simple urine tests can indicate the presence of UTI, which can be confirmed by urine culture tests. Followed by an antibiogram these allow doctors to prescribe antibiotics capable of eliminating the bacteria responsible for the infection.
If the patient is a young man with no signs of enlarged prostate, the doctor may order additional tests to identify the presence of abnormalities of the urinary tract, which can increase the likelihood of infection. UTIs are relatively rare in men young people with a normal urinary tract.
Drinking water regularly and treating signs of constipation early can decrease the incidence of UTI. Men should also avoid holding urine for long periods of time and should always completely empty their bladder during urination. Practicing safe sex through the use of condoms also helps prevent infections.
For men with benign prostatic hyperplasia, reducing caffeine and alcohol intake can help improve urine flow and prevent retention in the bladder, decreasing the likelihood of UTI. For some patients, doctors need to prescribe specific medications aiming to facilitate urine flow during the urination.
Although UTIs are often not considered serious and mostly experienced by women, men need to be aware of them and should not let symptoms go unchecked.
References:
- BRUSCH JL — Urinary Tract Infection (UTI) in Males: Practice Essentials, Background, Anatomy. Medscape. Jan 02, 2020.
- HARPER M, FOWLIS G — Management of urinary tract infections in men. In Trends in Urology Gynaecology & Sexual Health January/February 2007, pp 30–35.
- BENTON TJ — Infecção do trato urinário em homem — BMJ Best Practice — bestpractice.bmj.com/topics/pt-br/76
